3415 Wasting and Stunting Lecture

consequences of undernutrition

poverty undernutrition infection mortality

Kwashiorkor

"the disease that the first child gets when the new one comes" "sicknesss of weaning" older infants and young children (1-3 years) child removed from breastfeeding cannot meet protein needs marginal energy but not enough protein high carbohydrate but low quality/no protein

Marasmus

"to waste away" "dying away" most common form of acute malnutrition severe wasting lack of both quality protein and energy -body conserves energy -increased susceptibility to infection -can lead to death

Biological (causes and prevention)

Age - -In India prevalence of underweight increased quickly from 11.9% (<6 months) to 37.5% (6-11 months) to 58.5% (12-23 months). Similar findings with stunting. Why? Birth order - - First born has much lower incidence of undernutrition . 3rd born (48.5%) compared to 1st Born (20.3%) - Decrease in underweight when birth interval widens.

Stunting

Children who are short for their age Height falls below the median height-for-age of the World Health Organization's Child Growth Standards. Chronic malnutrition (42.7 % incidence in developing countries)

Wasting

Children who have a low weight in relation to their height Acute malnutrition/starvation Peak prevalence in 2 year of life 5% incidence worldwide

Causes of Undernutrition

Immediate causes: Inadequate dietary intake and disease. Poor feeding practices (breastfeeding and complimentary feeding) Poor food access/quality (recall food security) Frequent infections Basic causes: Starts before birth

Health care services (causes and prevention)

Supplementary nutrition, health checkups, growth monitoring Food distribution has been the focus - parental education about nutrition and feeding behaviors within the family budget have been largely ignored

How to feed children in rural areas during a famine?

Use of home-based therapy- benefits Ready to Use Foods- benefits Reading data tables correctly

Protein-Energy Malnutrition

a nutritional deficiency as a result of inadequate supply of protein and/or energy with respect to the body's demand for them for optimal growth and function.

Acute or chronic (PEM)

considered dominant cause of undernutrition

Undernutrition

indicates combined deficiencies in energy, protein, and fatty acids altered body composition likely low micronutrient nutriture-likely by low plasma micronutrient concentration or specific manifestations

During a famine

limited health care no trained health personnel

Environment (Causes and Prevention)

sociocultural factors maternal nutrition infection gender mother's literacy status poverty/income urban/rural differences